1. This systematic review found that despite the variability in spiritual interventions and patient outcomes, nearly all studies reported improved psychological and spiritual outcomes following nursing spiritual interventions.
2. Increased spiritual well-being was associated with existential based interventions and mixed interventions, whereas reduced levels of anxiety and depression were reported for existential, religious and mixed interventions.
Evidence Rating Level: 1 (Excellent)
Patients may become more involved with religious practices in clinical settings when they are faced with uncertainty of events. As nurses are often the ones who spend the greatest amount of time with patients, they are excellent candidates to offer spiritual interventions to such patients. Unfortunately, the role of these interventions are not well understood due to the diversity of implementation. As a result, the objective of the present systematic review was to synthesize the current evidence regarding nurses’ delivery of spiritual interventions and their impact on patient outcomes.
From 1005 screened records, 16 studies (n=1079 participants) were included from database inception to June 2020. Eligible studies required the evaluation of spiritual interventions (existential, religious, or mixed) delivered by nurses on psychological (e.g. anxiety, depression) and spiritual (e.g. spiritual wellbeing, quality of life) outcomes. Studies were excluded if interventions were provided by teams comprised of non-nursing colleagues. Quality assessment was performed using the Standard Quality Assessment Criteria for Evaluating Primary Research Articles (QualSyst tool). Narrative synthesis was used to group outcomes of interest to spirituality within the nursing context.
Results demonstrated that nearly all studies reported improved psychological and spiritual outcomes following the nursing spiritual interventions. Spiritual well-being was most associated with existential based interventions and mixed interventions, whereas levels of anxiety and depression were most associated with existential, religious and mixed interventions. However, the study was limited by its inclusion of 7 quasi-experimental studies which increased the risk of selection bias. Despite this, the present study presents a valuable contribution in understanding the impact of spiritual interventions on patient outcomes.
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